One evening you are sitting on your couch enjoying the football game, when suddenly your big toe starts throbbing! You can’t stand the pain and grab some ibuprofen which relieves the pain a little, but you struggle with this for several days and take a lot of pain relievers, which end up upsetting your stomach. A few months later that same big toe is at it again, very warm to the touch and feels like needles are in the joint causing excruciating pain. You ask your pharmacist who tells you that you may have gout!

What is GOUT?

Gout is just one of several joint problems that we can experience. Unlike other joint problems that deal with the loss of cartilage around the joints leading to bone on bone grinding, gout occurs due to excess accumulation of uric acid which crystallizes between the joints. I don’t know about you, but I don’t want needle like objects growing bigger and jagging out around my joints!

Why does gout occur?

Lets first talk a little bit about what uric acid is and where is comes from. Whatever we consume that comes from something that was once alive (meats, veggies, fruits, grains) contains DNA, and DNA is made up of a few cool little molecules including “purines”. Our body breaks up the DNA, and the purines become uric acid which is normally excreted through our kidneys. But, when we have too much uric acid, (due to too much consumed from food, or from our kidneys not working properly) we can have uric acid buildup, which can lead to crystallization in the joints (gout), or in the kidneys (stones).

What can I do to avoid gout?

Some people may be genetically predisposed to producing too much uric acid, so if someone in your family has it, you may be more susceptible. If you are overweight, have hypertension, consume moderate to large quantities of alcohol, use diuretics, or have kidney disease, you are a much higher risk for developing gout. Also, men are at a higher risk than women. However, for the majority of people, being mindful of certain foods can dramatically help to reduce risk and number of gout flare ups throughout the year. Certain foods have higher amounts of purines which eventually may cause you to have a gout flare. Foods to be mindful of are seafood (anchovies, sardines, salmon), all varieties of beans, and for you beer drinkers please drink only occasionally, and only in moderation. However research has shown that low-fat dairy products, exercise, smoking cessation, cherries and drinking lots of water have been shown to lower uric acid concentrations in the body or increase excretion through your kidneys. But, please note that the number one way to reduce risk of gout, according to the CDC, is weight loss.
If all fails, medications may be advised by your physician, which help with decreasing the amount of uric acid that is converted from the purines (Zyloprim/allopurinol, Uloric/febuxostat) or increasing the amount that is removed by your kidneys (Probalin/probenecid). You may also be prescribed a very popular anti-inflammatory medication called Colcrys/colchicine or Idocin/indomethacin, which works very well for gout flares. Unfortunately, you may still need relief for pain during a flare, but always follow your physician’s and pharmacist’s recommendations, and never take OTC pain relievers without checking with them first.

Will you get gout? No one really knows, but at least you know a little bit about what it is, how to avoid it, and how to treat it.

Wise Words…. is a general medical information column from Rebecca Miller Wise, MEd, PharmD, CGP. Dr. Wise has a master’s degree in education as well as her doctorate in pharmacy. She is a nationally board certified geriatric pharmacist and an assistant professor at a local medical college.